STATE OF MINNESOTA AND BLUE CROSS AND BLUE SHIELD OF MINNESOTA,
PLAINTIFFS,
V.
PHILIP MORRIS, INC., ET. AL.,
DEFENDANTS.
TOPIC: TRIAL
TRANSCRIPT
TRANSCRIPT OF PROCEEDINGS
DOCKET-NUMBER: C1-94-8565
VENUE: Minnesota
District Court, Second Judicial District, Ramsey
County.
YEAR: February
23, 1998
A.M. Session
JUDGE: Hon. Judge Kenneth J. Fitzpatrick, Chief Judge
THE CLERK: All rise. Ramsey County District Court is now in session,
the
Honorable Kenneth J. Fitzpatrick presiding.
(Jury enters the courtroom.)
THE CLERK: You may be seated.
THE COURT: Good morning.
(Collective "Good morning.")
THE WITNESS: Good morning, sir.
THE COURT: Good morning.
All right, counsel.
MR. WEBER: Thank you, Your Honor.
Good morning, ladies and gentlemen.
(Collective "Good morning.")
JAMES F. GLENN called as a witness, being previously
sworn, was
examined and testified as follows:
BY MR. WEBER:
Q. Good morning, Dr. Glenn.
A. Good morning, Mr. Weber.
Q. Dr. Glenn, when we stopped last Friday, we had
discussed your
background and credentials, the organization of the CTR, and the membership
of the Scientific Advisory Board. Do you remember?
A. Yes.
Q. I want to start today discussing the research
grant program of the
Scientific Advisory Board, and the first question I'll have for you
is
whether the CTR over the years has published reports summarizing the
research activity of its grantees?
A. Yes, sir. There has been an annual report since
the very beginning
of -- of CTR, or TIRC. The annual report embraces policy statement,
introduction, summary of activities of the preceding year, and then
abstracts of all of the articles published by investigators who were
supported by CTR during that year, and finally an index of all
investigators in the current volume and all prior investigators.
MR. WEBER: Your Honor, may I approach the witness
with this set of
exhibits?
(Box of documents handed
to the witness.)
Q. Dr. Glenn, I know you've looked through that
box before. Would you
confirm that that includes originals or copies of the annual reports
of The
Council for Tobacco Research?
A. Yes. These are -- are typical annual reports
of CTR.
MR. WEBER: Your Honor, let me hand up Exhibit 50002,
and at this time I
would move the admission through Exhibit 50002 of the annual reports
of The
Council for Tobacco Research.
MR. CIRESI: We have no objection, Your Honor, subject
to verification
that each exhibit relates to the specific annual report.
THE COURT: Are you going to read through all those,
counsel?
MR. CIRESI: I don't think so, Your Honor. I think
I'll just check to
make sure the year is the same as the number.
*2 THE COURT: Court will receive 50002.
BY MR. WEBER:
Q. Dr. Glenn, would you turn to Exhibit MD000084,
which is one of the
CTR annual reports. I believe it's the 1992 annual report.
A. Yes, sir.
Q. And using the 1992 annual report, I'd like you
to describe briefly
for the jury the contents of an annual report.
First of all, sir, is that the typical format for
a CTR annual report
during your tenure at CTR?
A. Yes.
Q. Now could you hold up the annual report for 1992
to the ladies and
gentlemen of the jury so they could see what we're talking about.
A. (Witness complies.)
Q. Thank you.
Now inside the front cover, Dr. Glenn, is a document
called
"Organzation and Policy." Correct?
A. Yes.
Q. And could you --
Is there anything in the organization and policy
you'd like to function
-- or to mention specifically to the ladies and gentlemen of the jury?
A. Well I think there are several important points
here: it dates our
origin back to 1954; it states that our support is from the tobacco
manufacturers, growers and warehousemen; states that the program has
been
one of grants-in-aid, which is research grants, supplemented by contracts
for research with institutions and laboratories; states that the council
does not operate any research facility; states that the Scientific
Advisory
Board meets regularly to judge the grant applications; and it states
that
the council awards research grants to independent scientists who are
assured complete scientific freedom in conducting their studies, and
the
grantees are responsible for reporting or publishing their findings
in the
accepted scientific manner.
Q. Dr. Glenn, could you continue to the table of
contents page.
A. Yes, sir.
Q. Bring that up just a little, if you could. Okay.
Now does this describe the -- or set forth what's
contained within the
annual report?
A. Yes, it does.
Q. Now it refers in the -- two of those early lines
to abstracts. Do
you see that?
A. Yes.
Q. What is an abstract in the scientific literature?
A. Well the abstract is a summary of a paper, and
virtually every
journal requires that there be an abstract paragraph by the authors
of the
study. The abstract details the reason for the research, the methods
used
in the research, the results and the author's conclusions from those
results. Those abstracts are published with the paper. We simply take
the
abstract from the paper and use it as a report in the -- in the journal.
Q. So the abstracts that are reprinted in the CTR
annual report are
simply reprints of abstracts from the scientific literature.
A. Yes.
Q. And down at the bottom of this table of contents,
does it show in
each annual report a list of all active projects?
A. Yes, sir.
Q. And does it have a list of all completed projects
over the years?
A. Yes, sir.
Q. And does it have an index of the principal investigators
over the
years?
A. It does.
Q. Could you turn, Dr. Glenn, to the introduction
page.
*3 A. Yes.
Q. Now as of 1992, approximately 204 million dollars
had been spent in
the council's research program; correct?
A. That's correct.
Q. Now it talks -- if we go down to the next paragraph
that begins
"Eighty- three...," could you read that paragraph to the ladies and
gentlemen of the jury.
A. "Eighty-three original projects were approved
in 1992; many more
continuing and renewal studies also were funded. To date, a total of
1,329
original investigations have been reported -- supported by the council.
Recipients for these are 932 independent scientists at more than 300
medical schools, hospitals and research centers."
Q. Now the next paragraph, Dr. Glenn.
A. "Council grantees published 342 reports on their
supported research
during the year. Abstracts of these are included in this report. The
total
for such publications now is at least 4,770."
Q. Now has that number grown for published reports
since 1992?
A. Yes, incrementally each year.
Q. Now could you turn, I believe, to the next page,
Dr. Glenn -- or
excuse me, go to page 21, if you would, please.
A. Yes, sir.
Q. And that page at the top is entitled "Abstracts
of Reports?"
A. Yes, sir.
Q. And that begins the reprints of the abstracts,
and they're broken
down by subject matter; correct?
A. Correct.
Q. And the first one, just as an example, I'd like
you to focus on is
this one which relates to the first in a series of cancer-related studies.
A. Yes, sir.
Q. Now are they listed --
Are the abstracts listed alphabetically by the name
of the grantee?
A. Yes, they are.
Q. Now this first one that's -- the beginning of
which is "Malignant
Epithelial Cells," do you see that?
A. Yes, sir.
Q. Down at the bottom, does that indicate who the
grantee is?
A. Yes. This was Dr. Harry Antoniades, who was a
professor at Harvard
University Medical School.
Q. Now --
And then does the next line advise as to where this
research was
published?
A. It was published in the Proceedings of the National
Academy of
Sciences in May 1992.
Q. Is the National -- Proceedings of the National
Academy of Sciences
one of the most prestigious scientific journals in the world?
A. Yes, sir.
Q. Have SAB members over the years been members
of the National Academy
of Sciences?
A. Yes, sir.
Q. Now was this research grant here supported by
funding from any other
research institute?
A. It is noted that other support in addition to
CTR was from the
National Institutes of Health.
Q. Now when CTR reprints these abstracts and talks
about other support,
where do they get the information as to who else has funded this research?
A. This comes from the paper itself. The investigators
will have a
footnote on the paper that says support for this research work came
from
the following sources, and it may say CTR grant number such and such,
may
say NIH and give the grant number, may say American Heart, American
Lung,
or whatever the source of other funding may be. Sometimes there are
several
sources.
*4 Q. Now does this reprinting of abstracts continue
by category
throughout the report?
A. I'm sorry, Mr. Weber?
Q. Does the reprinting of the abstracts by category
continue throughout
the report?
A. Yes, sir.
Q. Could you turn back to the table of contents
for a moment, Dr.
Glenn.
A. Yes, sir.
Q. And does that show that there are approximately
26 pages of
abstracts on cancer-related studies?
A. Yes, sir.
Q. And approximately 14 on the respiratory system?
A. Yes, sir.
Q. Approximately 36 on heart and circulation?
A. Yes.
Q. Approximately ten on neuropharmacology and physiology?
A. Yes.
Q. And approximately 103 on pharmacology, biochemistry
and cell
biology?
A. Yes.
Q. And approximately 28 on immunology and adaptive
mechanisms?
A. That's correct.
Q. And when listing the active projects, is that
approximately 24 pages
to list?
A. Yes.
Q. And completed projects, about 25 pages or so?
A. Yes, sir.
MR. CIRESI: Your Honor, all the questions are leading,
and I don't know
if this is preliminary, going to something, but I'm going to object
to the
leading nature of the questions.
THE COURT: Well they are leading, but I consider
it just preliminary.
BY MR. WEBER:
Q. Now let's discuss how the grant process works
that leads to the
funding of this research, if we could, Dr. Glenn.
When the SAB approves an application and advises
The Council for
Tobacco Research that it should be funded, is the funding provided
directly
to the researcher?
A. No, no. The funding goes to the institution in
which the
investigator is employed. The responsible fiscal authority for the
grant
will be the institution. For example, with the grant to Dr. Antoniades,
the
grant in that case, I think, was to the Harvard School of Public Health,
and they are responsible for reporting on expenditure of funds.
Q. When a researcher applies for a grant, what are
they advised as to
the policy of the CTR as to publication of research results?
A. Well they're universally advised that they are
encouraged to publish
their results, and specifically to report in accepted peer-reviewed
journals.
Q. Is the application for a grant a two-step process,
doctor?
A. Yes, sir.
Q. Could you describe that.
A. Well generally an investigator will learn of
CTR as a source from
one of its colleagues or perhaps at a medical meeting where someone
mentions support by CTR. They then will contact us by telephone or
by
letter, and we have response to them that indicates that we would like
to
see a preliminary proposal, which would be a two- or three-page letter,
not
in great detail or great depth. That preliminary inquiry, then, is
circulated to members of the Scientific Advisory Board, and if they
feel
like it's within our area of interest; that is, a project that we would
want to support, then the investigator is so advised and encouraged
to
develop the full grant application, which sometimes may run to 20 or
30
pages. So it's quite a bit of work to put together a grant application.
*5 In that application, that second application,
the final application,
they will detail the project, they will give a bibliography of background
information that's necessary to develop their -- their thesis, they
will
tell us of the methodology they intend to use, they will tell us who
else
will be involved in the project, they'll provide a brief resume of
their
own credentials and those -- and the credentials of the others who
work
with them, and then finally they will present us with a budget for
the
project, detailing how they would expend the funds that they're requesting.
Q. Dr. Glenn, could you briefly outline for the
jury the criteria
applied by the SAB when they receive a final application.
A. Well I think the first criterion, of course,
is merit, is this
project worthy of support in the -- in the view of the scientists who
do
the review? Secondly, I think they would consider whether this is --
will
add to the general body of knowledge in the particular field. I think
they
also consider its relevance to issues of smoking and health; that is
to
say, is this a fundamental problem that will shed light on the fundamental
disease processes that are going on in those diseases that are
statistically associated with smoking? They will look clearly at the
qualifications of the investigator. They look at the quality of the
institution from which the application comes. They make certain that
the
laboratory facilities and equipment are available and appropriate to
the
study that's being proposed. And I think those -- that covers generally
the
field that they would examine.
Q. During your tenure at the CTR, has the Scientific
Advisory Board
discussed factors such as legal implications, public relations
implications, or whether the companies themselves would approve or
not
approve of the research?
A. No, sir.
Q. Is the Scientific Advisory Board in fact an Advisory
Board?
A. It is.
Q. How -- how does that work?
A. Well obviously the final decision about the amount
of funding is
left to our staff and the administrative process. The Scientific Advisory
Board ranks the grant applications according to the criteria we've
discussed. This ranking is a numerical ranking. Each member of the
SAB
votes on a scale of one to five. Clearly we can develop a -- an average
score for each grant application that gives us a ranking system. The
staff
then accepts the recommendations of the Scientific Advisory Board and
may
make adjustments to budget. For example, if an investigator requests
a very
expensive piece of equipment and in our view this is something that
the
institution ought to undertake because it's going to be a long-term
acquisition for them, then we may say please send us a revised budget
indicating deletion of this particular piece of equipment, and the
investigators will almost universally respond in that way.
Q. Is there anyone who votes on the rankings other
than the SAB
members?
A. No, sir.
Q. Are you aware of a committee that was in existence
at one time known
as the Industry Technical Committee?
*6 A. Yes, sir.
Q. What was --
What's your understanding of what the Industry Technical
Committee was?
A. The Industry Technical Committee, I think --
I -- I've never met
with them or talked to them about this, but I think --
MR. CIRESI: Objection, it calls for speculation
and conjecture.
MR. WEBER: I'll lay some foundation.
THE COURT: You'll have to lay some foundation, counsel.
BY MR. WEBER:
Q. Given your experience at The Council for Tobacco
Research, have you
come to gain an understanding from its records and from the meetings
you've
attended as to what was the Industry Technical Committee?
A. I have.
Q. Could you explain that, sir.
A. Industry Technical Committee --
MR. CIRESI: Excuse me.
A. -- was made up of representatives --
MR. CIRESI: Excuse me, doctor. Excuse me. There
still is no foundation.
I don't know what documents he's referring to.
THE COURT: Can you give us a little more, please.
BY MR. WEBER:
Q. Dr. Glenn, have you, during your tenure at CTR,
met with an
individual who was a representative of the Industry Technical Committee?
A. I have met representatives of the Industry Technical
Committee, yes.
Q. Did industry -- members of the Industry Technical
Committee at any
time attend meetings of the Scientific Advisory Board?
A. In my early tenure with CTR, the Industry Technical
Committee would
send one representative to each meeting.
Q. And have you come to understand about whether
the Industry Technical
Committee would attend meetings of the SAB in prior years?
A. As I understand it, they did.
Q. Can you explain to me what your understanding
is of the Industry
Technical Committee?
MR. CIRESI: Your Honor, I'm going to object, again,
because now he says
that they attended, and just before, at --
"Question: What was your understanding of what the
Industry Technical
Committee was?
"The Industry Technical Committee, I think -- I
-- I've never met with
them or talked to them about this, but I think --"
And now he says that they were at meetings where
he was at. There's
still no foundation.
THE COURT: All right.
MR. WEBER: May I be heard?
THE COURT: Yes.
MR. WEBER: I mean he's made it clear that he said
he never met with the
whole committee, but he has met with representatives of the committee.
They
have attended meetings. He has a first-hand understanding of why they
were
there, and that's all I'm asking for, is him to explain that.
THE COURT: Okay. Are you going to be asking questions
about their
attendance at these meetings here?
MR. WEBER: Yes.
THE COURT: Okay. Go head.
BY MR. WEBER:
Q. What was your understanding as to the role that
a representative of
the Industry Technical Committee played at meetings of the Scientific
Advisory Board?
A. The representative who came to the meetings was
there only as a
consultant in case any question arose as to research that was being
accomplished by the industry, or to answer technical questions, usually
of
a chemical nature.
*7 Q. Did any member of the Industry Technical Committee
ever vote on a
grant application?
A. No, sir.
Q. Did company scientists ever vote on grant applications?
A. No, sir.
Q. By the way, would outside scientists from the
public health
community be invited from time to time to attend SAB meetings?
A. Yes.
Q. Can you explain that.
A. Well the CTR intended to maintain contact with
the general
biomedical research community and with public health officials, and
frequently there would be representatives from the American Heart
Association, American Cancer Society, the NIH, particularly the National
Cancer Institute, who would join the meetings. Not at voting members,
but
simply to be there for technical consultation if required.
Q. You mentioned NIH, Dr. Glenn.
A. Yes, sir.
Q. National --
That's National Institute of Health?
A. Yes.
Q. Now in addition to the grant process, did CTR
sometimes fund
research by contract?
A. Yes, sir.
Q. Was the contract research approved by the Scientific
Advisory Board?
A. Yes.
Q. Was it part of the Scientific Advisory Board's
research program?
A. Yes.
Q. Do other funding institutions use contracts occasionally
as well to
fund research?
A. Yes. I think virtually every funding organization
uses the contract
mechanism, including agencies of the federal government, and the reason
is
that generally the contract research that's -- that is specified is
of such
magnitude, such size, that one single laboratory or independent
investigator probably couldn't -- couldn't manage it himself. So the
contract work was usually limited to bigger projects.
Q. And does the National Institute of Health use
contract research?
A. Yes.
Q. How does the amount of funded research that went
through the SAB
program break down between grant research and contract research?
A. I've forgotten the exact figures, but I -- I
think currently -- or
in 1994 the amount of contract research would constitute less than
five
percent of the total budget.
Q. So the vast majority has been the grant program.
A. Yes.
Q. Dr. Glenn, what is CRT's policy regarding the
publication of
research results undertaken by researchers that the CTR SAB has funded?
A. Policy is that the -- as stated in the policy
statement --
investigators are encouraged to present and publish their results in
the
usual and accepted scientific manner.
Q. Have the results of CTR-funded research appeared
in leading
scientific journals throughout the world?
A. They have.
Q. Could you turn to tab 13, Dr. Glenn, and that
is Exhibit AM000204.
A. Yes, sir, I have that.
Q. And can you identify that as a listing of journals
and publications
in which CTR research has appeared?
A. I can, yes.
MR. WEBER: Your Honor, I'd move the admission of
Exhibit AM000204.
MR. CIRESI: No objection, Your Honor.
THE COURT: Court will receive AM000204.
BY MR. WEBER:
Q. Now Dr. Glenn, that list is approximately 29
pages long?
*8 A. It is.
Q. Let's start with U.S. journals and just go through
a few briefly.
Has research funded through the SAB appeared in
the Journal of the
National Cancer Institute?
A. It has.
Q. In a journal called Cancer?
A. Yes, sir.
Q. Is Cancer one of the world's leading journals?
A. Yes, sir.
Q. Cell?
A. Yes.
Q. Chest?
A. Yes.
Q. Circulation?
A. Yes.
Q. Immunology?
A. Yes.
Q. The Journal of Cell Biology?
A. Yes.
Q. The New England Journal of Medicine?
A. Yes, sir.
Q. In all the --
Would you say that the vast majority of the leading
U.S. medical
journals have carried reports of research funded by the CTR Scientific
Advisory Board?
A. Yes, as documented here.
Q. How about international journals, have -- has
work funded by the CTR
SAB program appeared in international journals as well?
A. Numerous international journals.
Q. Is The Lancet --
What's the reputation for a journal called The Lancet
in the medical
community?
A. Lancet is one of the oldest medical journals.
It is a British
journal. Probably I would have to say if not the most respected, one
of the
most respected journals in the world.
Q. Has research funded by CRT's SAB appeared in
The Lancet?
A. Yes.
Q. In the British Journal of Cancer?
A. Yes.
Q. British Medical Journal?
A. Yes.
Q. How about leading French and European journals?
A. There also.
Q. Italian journals?
A. Yes.
Q. Israeli?
A. Yes.
Q. Scandanavia?
A. Yes.
Q. Germany and Japan?
A. Yes, sir.
Q. Has the United States Public Health Service ever
cited research
funded by the scientific Advisory Board in its Surgeon General reports?
A. Yes. I think cumulatively probably 300, 350 times.
Q. To your knowledge, has The Council for Tobacco
Research ever
suppressed the publication of research it funded?
A. No.
Q. Let's discuss now briefly some of the institutions
where CTR-funded
research has been conducted and some of the researchers, starting right
here. Could you turn to tab 14, Dr. Glenn.
A. I have it.
Q. That's demonstrative Exhibit 1925B, as in blue.
Can you identify
that document, Dr. Glenn? Is it a demonstrative chart relating to funding
in the state of Minnesota?
A. It is. These are CTR grantees in the state of
Minnesota.
Q. Dr. Glenn, before you go ahead, I need to move
it into evidence.
MR. WEBER: I'd like to move for demonstrative purposes,
Your Honor, the
admission of Exhibit 1925B.
MR. CIRESI: No objection, Your Honor.
THE COURT: Court will receive 1925B for demonstrative
purposes.
BY MR. WEBER:
Q. And can you describe just briefly what this is,
Dr. Glenn?
A. This is entitled "CTR Grantees in Minnesota."
Q. (Coughing) Excuse me.
And does it list those people who have received
grants from the
Scientific Advisory Board and conducted research in this state over
the
years?
A. It does.
Q. Has the CTR Scientific Advisory Board funded
research across the
United States as well, Dr. Glenn?
*9 A. Oh, it has, in virtually every state.
Q. Can you turn to tab 15. That's Exhibit 19 --
demonstrative Exhibit
1970.
A. Yes.
Q. Is that a chart demonstrative showing the geographical
spread of CTR
grant research?
A. It is.
MR. WEBER: Your Honor, I'd move the admission for
demonstrative
purposes of Exhibit 1970.
MR. CIRESI: No objection, Your Honor.
THE COURT: Court will receive 1970 for demonstrative
purposes.
BY MR. WEBER:
Q. Can we pull that up or not? Okay. Put the --
well, sorry I can't get
that to look any better.
Is this a chart that represents funding across the
country?
A. This is a map of the United States, and representative
grantee
institutions are listed here. This is not a complete list, but it does
show
the geographic distribution of grants that have been made over the
years.
Q. Has CTR funded research of major United States
universities?
A. Yes.
Q. Let me go through just a representative list
with you. And answer
"yes" or "no" on each one as to whether research has been funded there
through the SAB.
At Duke?
A. Yes.
Q. At Yale?
A. Yes.
Q. At Harvard?
A. Yes.
Q. MIT?
A. Yes.
Q. Stanford?
A. Yes.
Q. University of Chicago?
A. Yes.
Q. University of Minnesota?
A. Yes.
Q. University of Wisconsin?
A. Yes.
Q. Iowa University?
A. Yes.
Q. University of Michigan?
A. Yes.
Q. Johns Hopkins?
A. Yes, sir.
Q. Penn?
A. Yes.
Q. University of California?
A. Yes.
Q. Cornell?
A. Yes.
Q. Many others?
A. Yes.
Q. Has CTR also funded research at major biomedical
research
institutions in the United States and abroad?
A. It has.
Q. At the Dana Farber Institute?
A. Yes.
Q. Where is that located, doctor?
A. In Boston.
Q. And what is that?
A. It is a research institute that is affiliated
with the Harvard
Medical School and several of the Harvard hospitals.
Q. At the Mayo Clinic?
A. Yes.
Q. At the Fox Chase Cancer Center?
A. Yes.
Q. What is the Fox Chase Cancer Center?
A. Fox Chase is an independent cancer research institution
which has
affiliations with the Philadelphia Medical School.
Q. At the Scripps Institute?
A. Yes.
Q. Is that a major funder and performer or --
Is that a major research institution?
A. It is, and -- and a major clinical institution
as well, the Scripps
Clinic and Scripps Hospital.
Q. And has CTR funded research in overseas research
institutions?
A. Yes.
Q. Including the Karolinska Institute?
A. Yes.
Q. Where is that located?
A. In Stockholm, Sweden.
Q. Are you generally familiar with the reputations
of the institutions
and investigators and researchers who have been funded through the
SAB
grant program?
A. I am.
Q. And what is that reputation in the biomedical
community?
A. Well, I think, you know, these are the top institutions,
and the
investigators have been of first-rank quality, respected by their peers,
acknowledged by the biomedical research community to be outstanding
contributors.
*10 Q. You mentioned on Friday that one SAB member
had been nominated
for a Nobel Prize?
A. Well as a matter of fact three of them have.
Q. Members of the Scientific Advisory Board over
the years?
A. Yes.
Q. Have any of the CTR grantees ever been nominated
for the Nobel
Prize?
A. Yes, many of them, and three of them have --
have won the Nobel
Prize.
Q. Can you identify these grantees of CTR who have
won Nobel Prizes?
MR. CIRESI: Objection, Your Honor, it's irrelevant.
THE COURT: Oh, you may answer that.
THE WITNESS: Answer it, Your Honor?
THE COURT: Yes.
A. Dr. Baruch Benacerraf at Harvard won the Nobel
Prize. We supported
Dr. Benacerraf for a number of years. His work was in the area of molecular
biology. He's really considered to be a pioneer of molecular biology.
Second one was Dr. Stanley Cohen, whose work was
with growth factor.
Dr. Cohen is professor at Vanderbilt University Medical School in
Nashville. Dr. Cohen was the person who really opened up the field
of
growth factor. Growth factor is a substance that is virtually essential
for
cell proliferation, for cell growth.
And the third individual who won the Nobel Prize
for his work in
oncogenes, the cancer-causing gene, was Dr. Harold Varmus, who was
then
professor at the University of California-San Francisco, but who is
now the
director of the National Institutes of Health.
Q. And were these researchers awarded their Nobel
Prizes for research
in areas that included the areas that CTR had funded them in?
A. Yes, sir.
Q. Do CTR grantees typically get all of their research
funding from
CTR?
A. Oh, no. As a matter of fact, our funding many
times was in the form
of seed money, something to help get a project started. Our grants
were not
huge grants for the most part, 80, 85 thousand dollars a year, but
it would
get an investigator started on a given project. And usually those that
were
off to a successful start could then attract major funding from federal
funding sources.
Q. How does CTR know who -- what other institutions
may be funding a
researcher that they're funding?
A. Well in the grant application an investigator
is asked to list the
sources of funding that he has currently, as well as pending funding;
that
is, where he may have applied for additional funding, and of course
when we
receive the report from the investigator year by year, we know what
other
funding he's gotten because he tells us.
Q. And is it also disclosed in publications eventually?
A. Yes, as we discussed.
Q. And is it of any significance to those of you
affiliated with CTR
and the Scientific Advisory Board as to the fact that researchers funded
through the SAB program are also getting funding from other sources?
A. Well I think it's reassurance that our judgment
was correct in the
first place.
Q. Let me turn now to some changes in CTR over the
years, if I might,
Dr. Glenn.
During your tenure at CTR, has CTR engaged in any
active public
information, public affairs, public relations activities?
*11 A. No.
Q. Does CTR send out routine press releases any
more in your tenure?
A. Once a year we send a brief press release announcing
the publication
of the annual report, and it usually -- this little, brief blurb usually
says how much money we have expended for research grants during the
-- the
past year, the number of grantees that we've supported, and the cumulative
experience in supporting biomedical research, and that's about the
size of
it.
Q. And are the annual reports distributed to medical
schools and
medical libraries throughout the country?
A. Every medical school in North America, the deans
of all the medical
schools; also to all of our current and former grantees, we send a
copy of
the annual report so they can see for themselves the progress; these
reports are also sent to major newspapers along with the brief press
release.
Q. Based on your understanding of the history of
CTR -- and I know you
don't know everything, but based on what you do know -- do you know
whether
CTR in its earlier years played a more active or different role with
respect to public information and press activity?
A. Yes, they were more active.
Q. And did that activity diminish over time?
A. It did.
Q. Could you explain that for us in terms of your
understanding.
A. Well in the beginning, you know, under the terms
of the Frank
Statement, the TIRC, later the CTR, was charged with not only supporting
an
investigative program, but also with making public the information
that was
developed. By just -- within just a few years it was recognized that
the
public information charge was more appropriately done by another agency,
and The Tobacco Institute was formed, and it gradually took over the
function of public information.
Q. Do other research funders and other research
institutions have
public affairs or public relations offices?
MR. CIRESI: Objection, foundation, hearsay, irrelevant.
THE COURT: Sustained.
Q. Dr. Glenn, have the academic institutions and
hospitals that you've
been associated with over the years also had public relations or public
affairs offices?
MR. CIRESI: Objection, irrelevant.
THE COURT: Sustained.
Q. Dr. Glenn, what function, based on your knowledge,
do public affairs
or public information offices that are affiliated with universities
or
research institutions serve?
MR. CIRESI: Objection, irrelevant, foundation.
THE COURT: Sustained.
Q. Dr. Glenn, to your knowledge, did any public
relations activity at
CTR affect the quality of any research that was being done?
A. No, sir.
Q. Let me ask now about another change over the
years. Did CTR once
fund research through what was called CTR special projects?
A. Yes.
Q. When did CTR special projects begin, Dr. Glenn?
A. I believe in about 1965.
Q. Do you know when they ended?
A. About 1990.
Q. Was the CRT's scientific director involved at
all in approving CTR
special projects?
A. Yes. The scientific director reviewed every special
-- CTR special
project that was proposed by the sponsors, reviewing it primarily for
scientific merit, whether he thought it would add anything to the body
of
knowledge in the -- in the general field.
*12 Q. Did you approve any research of CRT's special
projects when you
were scientific director?
A. Not new projects, because the project -- the
special projects of CTR
were gradually winding down. I did approve a renewal of one of the
CTR
special projects.
Q. Do other funding institutions such as the National
Institutes of
Health use the term "special projects" to designate certain of their
research?
MR. CIRESI: Objection, Your Honor, it's irrelevant,
there's no
foundation.
THE COURT: Sustained.
MR. WEBER: Let me ask -- let me see if I can lay
some foundation here,
Your Honor.
MR. CIRESI: Your Honor, I'm going to object also
on irrelevance.
THE COURT: Okay. I don't know what that has got
to do with this case,
counsel. Why don't you move on.
MR. WEBER: Can I -- well can I try to ask one question,
see if I can
address this, Your Honor? I think it might address the court's concern.
THE COURT: Okay.
BY MR. WEBER:
Q. Does the term "special project" or "National
Institute of Health
special project" have a recognized meaning in the research community?
A. It does.
MR. CIRESI: Objection. Excuse me, doctor. It's irrelevant.
THE COURT: No, you may answer that.
Q. Dr. Glenn, would you like the question again
or do you remember it?
A. I remember the question.
Q. Okay.
A. The National Institutes of Health does have a
public relations
function and they do --
MR. CIRESI: Your Honor, --
MR. WEBER: No, --
MR. CIRESI: -- that's not --
MR. WEBER: -- that was not the question.
MR. CIRESI: Excuse me.
THE COURT: Okay. Do you want to try --
MR. CIRESI: He's given an answer to a different
question. I don't know
where that came from.
THE COURT: Okay. Do you want to try it again, counsel?
MR. WEBER: Yeah, I'll ask it again.
THE COURT: Okay.
BY MR. WEBER:
Q. Dr. Glenn, does the term "special project" or
"National Institute of
Health special project" have a recognized meaning in the medical research
community?
A. Yes.
Q. What does that mean to those of you in the medical
research
community?
MR. CIRESI: Again, Your Honor, I'm going to object
on relevance
grounds.
THE COURT: No, you may answer that.
A. Special projects are projects supported by the
NIH or another agency
with a specific purpose. It's more in the line of contract research
than it
is the usual competitive grant-in-aid.
Q. Were CTR special projects handled separately
from the SAB grant
program?
A. Yes.
Q. Were CTR special projects reported in the annual
report?
A. No.
Q. Did funds for CTR special projects come out of
the or take away from
the Scientific Advisory Board's research budget?
A. No. They were independently funded.
Q. How did the amount spent on CTR special projects
over the years
compare to that spent on -- the money spent in the grant program?
MR. CIRESI: Objection, Your Honor, it's already
been testified to. We
put a document in on his cross-examination with regard to it.
*13 THE COURT: Okay. I think we covered it once.
I'll -- I hope we
aren't going to go into depth again; are we?
MR. WEBER: No, we're not.
THE COURT: Okay. Go ahead.
Q. Go ahead, do you remember --
A. I don't remember the exact figures, but it amounts
to only a
fraction of the total SAB grant funds.
Q. Did you understand that CTR special projects
were suggested by the
sponsors of CTR?
A. Yes.
Q. Do you know whether lawyers may have suggested
some of those
projects to the sponsors?
MR. CIRESI: Objection, Your Honor, he testified
last Friday he didn't
know.
THE COURT: Okay.
MR. WEBER: Well may I respond?
THE COURT: You're going to respond to counsel?
MR. WEBER: Yes.
THE COURT: I thought we were going to have a question
and answer
between the attorney and the witness. Okay.
MR. WEBER: Yes, I'm sorry.
THE COURT: If you have a question, ask the witness.
MR. WEBER: I'm sorry, I didn't hear the ruling on
that, Your Honor.
THE COURT: Okay. The ruling is overruled.
MR. WEBER: Excuse me. I'm still a little stuffed
up, so I -- excuse me.
BY MR. WEBER:
Q. Do you remember the question, Dr. Glenn?
A. No.
Q. Okay. Did you have an understanding as to whether
lawyers may have
been people who suggested to the sponsors that certain special projects
be
done?
A. I didn't understand that, but it's not unreasonable
that they would
have been consulted.
Q. Does the fact that the sponsors or perhaps even
their lawyers may
have suggested that certain research be funded make that research itself
unreliable?
MR. CIRESI: Objection, it's speculation, there's
no foundation for this
witness.
THE COURT: Well what you're -- you are getting very
leading, counsel. I
wonder if you could --
MR. WEBER: Okay.
THE COURT: -- make your questions a little more
general.
BY MR. WEBER:
Q. Does -- how do scientists -- strike that. Does
the --
Does who sponsored the research control the question
of whether
research is reliable or not?
A. No.
MR. CIRESI: Excuse me, doctor. Your Honor, I'm going
to object to that.
Whose research? In what year? There's no foundation, it's vague and
overbroad.
THE COURT: I expect you will ask him something more
specific. I'll
allow the question and you may answer it.
A. No, sir.
Q. Go ahead.
A. The source of funding does not dictate the quality
or the type of
research.
Q. In your 46 years in academic medicine and being
involved in research
and being on funding organizations, do you have an understanding as
to how
scientists judge the quality of published research?
A. Yes.
Q. How is that done?
A. Well the presentation of scientific research
may be in the form of a
verbal presentation, oral presentation at a medical meeting. Papers
to be
presented at a medical meeting are reviewed by a committee of peers,
of
people who are knowledgeable in that area. And it's competitive. They
are
not going to accept -- at a qualified medical meeting they will not
accept
presentation of shoddy or inaccurate research.
*14 The same thing holds true for publication. The
articles submitted
for publication in these hundreds of medical journals are reviewed
by an
editorial board of peers, people who are knowledgeable in the field,
and
those papers that are -- are not of quality are rejected.
Q. Dr. Glenn, have you come --
Do you have an understanding as to why CTR special
projects were funded
through CTR?
A. Yes.
Q. Could you explain that.
A. I think it was purely a matter of convenience.
The funding mechanism
in medical research institutions, medical schools, clinics, hospitals,
is
different from the usual course of business. Each institution will
have a
grants and contracts office, and they will have a financial officer
that is
in charge and is responsible for receiving the funds.
CTR staff were accustomed to dealing with institutions
and providing
the funds and receiving reports of expenditure of funds, so it was
a
convenience for the sponsor companies simply to fund these special
projects
of CTR through the CTR offices.
Q. Has CTR compiled a list from its records of CRT's
special projects?
A. Yes.
Q. Could you turn to tab 16, Dr. Glenn, and that
would be Exhibit
AM005003.
A. Yes, I have it.
Q. Can you identify that as a list from CRT's records
of CRT's special
projects?
A. Yes.
MR. WEBER: Your Honor, I'd move the admission of
Exhibit AM005003, a
list of special projects of CTR.
MR. CIRESI: I have no objection to this, Your Honor.
THE COURT: Court will receive AM005003.
MR. WEBER: (Coughing) Excuse me.
BY MR. WEBER:
Q. Approximately how many CTR special projects were
there, Dr. Glenn?
A. Approximately 110.
Q. Were all CTR special projects original laboratory
or scientific
research?
A. Not in the early days. I think there were some
focus studies that
were epidemiological surveys, literature reviews, but toward the end
of the
special projects they were original research, yes.
Q. Did CTR have a policy regarding the publication
of research results
resulting from original research in CRT's special projects?
A. Yes.
Q. What was that policy?
A. The same policy that we had for grants and contracts,
and that was
that publication was the responsibility of the investigator, and they
were
encouraged to -- to present or publish their work in the standard
scientific manner.
Q. Dr. Glenn, could you turn to tab 17.
MR. WEBER: And Your Honor, may I approach? It's
another composite
exhibit list.
Do we have a copy for Mr. Ciresi?
BY MR. WEBER:
Q. Dr. Glenn, does tab 17 collect funding letters
to researchers
receiving CTR special projects?
A. Yes, sir.
Q. And is that a complete collection of the letters
that exist in
informing a researcher of their approval as a special project for CTR
as
from the files of CTR?
A. Yes, it does.
MR. WEBER: Your Honor, I'd move the admission through
Exhibit 50003,
which lists numbers, of the exhibits listed thereon.
MR. CIRESI: Once again, Your Honor, we have no objection
in order to
expedite matters, so long as we have an opportunity to verify.
*15 THE COURT: All right. Court will receive Exhibit
50003.
BY MR. WEBER:
Q. Now Dr. Glenn, could you turn within tab 17 to
the exhibit listed
MD001076.
A. It's going to take me a long time to find that,
counselor.
Q. Well why don't we do it this way then. Why don't
you --
Oh, these are the numbers on the left-hand side,
Dr. Glenn. That might
make it easier.
A. Oh, I'm sorry.
MR. WEBER: May I approach, Your Honor, to speed
this up?
Q. See the exhibit numbers down here, Dr. Glenn?
Wait, you're almost
there. MD001076. Do you see that?
A. Correct.
Q. And I will ask you a couple more of these, and
that's where you'll
find those numbers.
Can we bring that up?
Now is this a letter sent to a researcher who was
going to receive CTR
special project funding?
A. Yes.
Q. And can you describe or read that letter and
explain its purpose at
CTR.
A. Well it's to Dr. Doris Herman in the Department
of Pathology,
University of Southern California in Los Angeles, refers to a letter
of May
25th confirming the financial assistance which she had requested. It's
written by Dr. Hoyt, who said he inadvertently failed to mention that
our
records will designate your undertaking as a special project of The
Council
for Tobacco Research rather than a grant-in-aid, and it further tells
her
that if a credit line should be inserted into any future publication,
it
should be so worded in order to avoid its being confused with the grant
program of the Scientific Advisory Board.
Q. Now Dr. Glenn, could you continue on to MD001108,
which is another
letter. And maybe to make it quicker, Dr. Glenn --
A. I have it.
Q. Okay. And that's a letter to Dr. Macdonald?
A. No, sir, --
Q. Okay.
A. -- I don't have it.
Q. Why don't you look on the one on the screen then.
Is that 1108?
A. Yes.
Q. All right. That's a letter to Dr. Eleanor Macdonald?
A. Yes.
Q. Okay. And again in that second-to-the-last paragraph,
could you read
that?
A. "Our records will designate this undertaking
as a special project of
The Council for Tobacco Research-U.S.A., Inc., rather than a grant-in-aid.
If a credit line should be inserted into any future publications, it
should
be worded to avoid its being confused with the grant program of the
Scientific Advisory Board."
Q. All right. And are these examples we've seen
consistent with the
types of letters that were sent to special project recipients?
A. Yes. I -- I have reviewed many of these letters,
and they all
contain similar wording.
Q. Generally they all contain that wording.
A. Yes.
Q. Now did CTR special project researchers in fact
publish their work?
A. Yes.
Q. Are the publications of CTR special projects,
research of which CTR
is aware, listed in Exhibit AM005003, which is at tab 16, and that's
the
list of special projects that were admitted into evidence just a little
earlier?
A. Yes.
Q. And you've reviewed that list; haven't you, doctor?
*16 A. Yes, sir.
Q. Were the results of CTR special project research
generally published
in quality scientific peer-review journals?
A. Generally, yes.
Q. Did research funded of CTR special project research
include research
undertaken at quality institutions?
A. Yes, sir.
Q. Can you turn to tab 18, which is Exhibit 1217.
A. I have it.
Q. And is that a representative -- demonstrative
chart representing
some of the institutions that received special project research?
A. Yes, sir.
MR. WEBER: Your Honor, I'd move the admission of
Exhibit 1217 for
demonstrative purposes.
MR. CIRESI: No objection, Your Honor.
THE COURT: Court will receive 1217 for demonstrative
purposes.
BY MR. WEBER:
Q. Now are these some of the institutions that have
received CTR
special project funding, Dr. Glenn?
A. Some, but not all. This is not an inclusive list.
Q. And are these quality research institutions?
A. Absolutely.
Q. Did other quality funding organizations also
support research and
researchers who were at the same time being supported by CTR special
project funding?
A. Yes.
Q. Could you turn to tab 19, which is demonstrative
Exhibit 1218.
A. I have it.
Q. Is that a listing of some other organizations
that also funded CTR
special project research?
A. It is.
MR. WEBER: Your Honor, I'd move the admission of
Exhibit 1218 for
demonstrative purposes.
MR. CIRESI: No objection, Your Honor.
THE COURT: Court will receive 1218 for demonstrative
purposes.
BY MR. WEBER:
Q. Now how is it that CTR developed this representative
list of other
organizations that were funding CTR -- were funding research that was
also
being funded as a CTR special project?
A. Well again, this would come from the footnote
credit line of the
papers published by the investigators where they would acknowledge
support
by CTR as a special project, along with support from one or more of
these
additional institutions and other agencies as well.
MR. WEBER: Your Honor, I'm going to take a slight
change in topic here,
and I can take a break whenever the court would want. I just --
THE COURT: All right. Well let's take a short recess
now.
MR. WEBER: Okay.
(Recess taken.)
THE CLERK: All rise. Court is again in session.
(Jury enters the courtroom.)
THE CLERK: Please be seated.
MR. WEBER: Thank you, Your Honor.
BY MR. WEBER:
Q. Dr. Glenn, last week Mr. Ciresi asked you some
questions about
several specific research projects, and I want -- I want to follow
up on
some of that inquiry.
Do you recall questions about a 1971 proposal to
fund the research at
Washington University --
A. Yes, sir.
Q. -- regarding immunological issues and cancer?
A. Yes.
Q. Was that ever funded as a CTR special project?
A. Not according to my record review.
Q. Was it ever funded as a CTR grant?
A. Not to my knowledge, no.
Q. Do you know if it was ever funded in some other
manner by the
companies?
*17 A. No.
Q. You have no knowledge one way or the other.
A. I do not.
Q. Mr. Ciresi also asked you some question about
grants to researchers
who were named Spielberger and Aviado. Do you remember that?
A. Yes.
Q. And he questioned whether CTR might have suppressed
that research.
Do you remember that question?
A. Yes.
Q. Did CTR fund a researcher named Spielberger with
a CTR special
project?
A. Not according to our records.
Q. Did CTR fund a researcher named Spielberger with
a grant?
A. No.
Q. You have no knowledge whatsoever about any research
performed by
Spielberger.
A. No.
Q. Did CTR fund Dr. Aviado with a CTR special project?
A. I believe so.
Q. Do you know if that is the project referred to
in the document that
Mr. Ciresi showed you?
MR. CIRESI: Objection, Your Honor, foundation.
THE COURT: Okay. Well you may answer that.
A. Dr. Aviado also was a grantee. I'm not sure which
is referred to.
Q. Or whether it's some other project.
MR. CIRESI: Well, Your Honor, I'm going to object
to counsel's leading
question. There's no foundation.
THE COURT: Yeah, that was leading, counsel. Sustained.
Q. Do you know --
Do you know what specific project was referred to
in the document Mr.
Ciresi showed you?
MR. CIRESI: Objection, no foundation. The witness
has just testified.
THE COURT: I believe he's answered that, counsel.
BY MR. WEBER:
Q. With respect to the CTR special project funding
for Dr. Aviado,
could you turn to page -- to tab 23. And these are exhibits that are
already in evidence, MD001143, MD001150. Those are part of the special
project letters that were admitted earlier.
A. I have them.
Q. And let me show you first Exhibit 001143. Do
you have that one?
A. I do.
Q. January 1978?
A. Yes, sir.
Q. And does that talk about Dr. Aviado's right to
publish in the
future, down in the second-to-the-last paragraph?
A. Yes.
Q. And is this a typical letter to a CTR special
project recipient?
A. Yes, it is, similar to the previous letters that
we reviewed.
Q. And could you turn to Exhibit 1150, which I believe
should be next
in your tab. Do you see that?
A. I have it.
Q. That relates to the same special project number
93?
A. Yes, sir.
Q. Does that also refer to potential future publication?
A. Yes.
Q. Do you have any information that CTR ever did
anything to advise Dr.
Aviado not to publish?
A. No.
Q. Did CTR ever fund projects through device or
an account called
special account four?
A. I don't know what special account four is.
Q. Does CTR have any files that include -- that
are labeled special
account four?
A. No.
Q. Did CTR ever fund research through anything called
lawyers' special
projects?
A. No.
Q. Does CTR have a file for lawyers' special projects?
A. No, sir.
Q. To the best of your knowledge, doctor, and taking
into account your
46 years in academic medicine and your work in the research community,
do
you believe that it was unethical or improper for CTR to fund research
as
CTR special projects?
*18 MR. CIRESI: Objection to the form, no foundation,
calls for an
expert opinion, and also calls for an ultimate conclusion of fact by
the
jury.
THE COURT: Sustained.
BY MR. WEBER:
Q. Based on your knowledge from your review of materials,
do you
believe that CTR did anything improper or unethical with respect to
funding
CTR special projects?
MR. CIRESI: Same objections, Your Honor.
THE COURT: Sustained.
Q. Dr. Glenn, would you turn to Exhibit 11028. It's
at tab 24. It's an
exhibit already in evidence.
A. I see that.
MR. CIRESI: Do you have a exhibit number, counsel?
MR. WEBER: 11028.
Q. Is that one of the documents that Mr. Ciresi
showed you last week?
A. Yes, sir.
Q. I'd like you to turn to the front page of that.
Do you know any of
these individuals, Bentley, Felton or Reid?
A. No.
Q. Do you know what their scientific capabilities
were?
A. No.
Q. Is this a document that was in CRT's files?
A. No.
Q. Had you ever seen this document as part of your
duties at CTR, apart
from litigation?
A. No, sir.
Q. Turn to the first page, which is the itinerary.
You remember Mr.
Ciresi asking you some questions about that?
A. Yes.
Q. Is --
At the time was R. J. Reynolds a sponsor; that is,
in 1958 was R. J.
Reynolds a sponsor of TIRC?
A. Yes, they were.
Q. Was R. J. Reynolds visited on this trip?
A. No, sir, not according to this itinerary.
Q. According to this itinerary was Lorillard visited
on this trip?
A. No, sir.
Q. According to this itinerary was Brown & Williamson
visited on this
trip?
A. Not according to this itinerary.
Q. Could you take a look through that document and
let me know whether
it purports to quote directly anyone from the CTR?
A. I've reviewed this document previously, and I
found no direct quotes
from anyone at CTR.
Q. Are you able to vouch for the accuracy of any
of the
characterizations of conversations in there, sir?
A. No.
MR. CIRESI: Excuse me, doctor. That calls for speculation.
He's already
said he's never saw it before.
THE COURT: No, he can answer the question. It's
been answered.
MR. WEBER: He can? He can answer?
THE COURT: He's already answered.
MR. WEBER: Okay. I'm sorry, Your Honor.
BY MR. WEBER:
Q. Let me ask you this, Dr. Glenn: Could you read
that bottom paragraph
on the page marked 492 from this document.
A. "The SAB," Scientific Advisory Board, "of TIRC
and the group we at
the National Cancer Institute, Bethesda, broadly take the view that
causation is likely to be indirect. Several hypothetical means by which
this could occur were proposed but with no experimental evidence to
support
any of them."
Q. All right. And I'd like to go to the next page,
493, and ask if you
could read that first paragraph under "EXTRAPOLATION FROM ANIMAL TESTS
TO
MAN."
A. "Without exception no single individual whom
we met was prepared to
extrapolate unambiguously from any single animal test to man. At the
same
time there was general agreement that in the field of smoking and lung
cancer no biological test wholly free from criticism is available at
the
present time or is likely to become available in the foreseeable future."
*19 Q. Now does that express an opinion that you
agree with, Dr. Glenn?
A. Yes. I would certainly have agreed at that time,
40 years ago, and I
-- I think we still have the ambiguities.
Q. Could you go to the page labeled 496.
A. I have that.
Q. And start at the paragraph that begins at the
bottom of the page and
goes over to the next page. Could you read that paragraph.
A. "Others, including the Scientific Advisory Board
of TIRC and a group
at the National Cancer Institute, do not accept that a case has yet
been
made that tobacco smoke is directly carcinogenic to the human lung.
While
accepting broadly that cigarette smoking may be said to be capable
of,
quote, causing, unquote, lung cancer they argue that the evidence favors
some indirect mechanism of causation. If this is so, of course, cancers
produced by skin painting, and even more so, cell changes produced
by
short-term screening tests are misleading artifacts. Unfortunately
so long
as the basic problems underlying the transformation of a normal to
a
cancerous cell remain unsolved, theories of indirect causation must
be
largely speculative and almost without exception incapable of being
tested
experimentally. The advice we had from this group, which includes Dr.
Little, was that T.M.S.C. should concern itself less with direct testing
of
cigarette smoke on animals than with fundamental work on carcinogenesis.
An
idea which we frequently encountered was that of an institute financed
say
by T.M.S.C. which would support a number of dedicated individuals of
proved
caliber who would devote their time to long range basic research on
cancer
without being distracted by administrative duties or financial worries.
No
short or medium-term solution to the problems facing the industry could
be
expected from such an institution, which would necessarily have to
have no
strings attached, but very long-term beneficial results might be expected."
Q. Could you turn back to page 492, Dr. Glenn, and
in the paragraph
labeled "'CAUSATION' OF LUNG CANCER" -- do you see that?
A. Yes, sir.
Q. Could you begin reading where it talks about
Hueper of the National
Cancer Institute. Do you see that?
A. Yes, sir.
Q. Could you read that.
A. "Hueper of the National Cancer Institute accepts
that cigarette
smoke is capable of causing lung cancer but believes that as compared
with
other environmental carcinogens the contribution of smoking to the
total
mortality from lung cancer is being greatly exaggerated."
Q. Now doctor, turn to page 498, please.
A. Yes.
Q. Do you see the second conclusion down there --
A. Yes.
Q. -- at the bottom of the page? That hasn't been
read to the jury yet.
Could you read conclusion two.
A. Conclusion two states: "There remains an area
of debate to what is
meant by, quote, causation, end quote. Opinion differs as to whether
or not
cigarette smoke is likely to exert its effect by direct action on the
lung.
An indirect mechanism of causation is thought by some to be more likely."
*20 Q. Now, sir, this was in a 1958 document?
A. Yes.
Q. And again, you don't know the authors or the
accuracy of the report;
correct?
A. No.
Q. Did you take a look to see what the Scientific
Advisory Board itself
said in this same period about the issue of causation?
A. I think they were saying the same things, that
there were real
questions as to whether there was a direct effect on the lung of cigarette
smoking.
Q. Did you look at the minutes of the Scientific
Advisory Board --
A. I did.
Q. -- to -- to determine what the Scientific Advisory
Board itself said
about this issue of causation?
A. Yes.
Q. Could you turn to the Scientific Advisory Board
minutes, which is
Exhibit MD001258, I believe. Those should be in a separate binder up
there.
They were admitted into evidence already.
A. Tell me the number again, please, sir.
Q. It's Exhibit MD001258. Those are the minutes
of the Scientific
Advisory Board.
A. Yes.
Q. May I approach --
A. I have those.
Q. Okay. And could you turn to the page that is
Bates stamped at the
bottom 153.
A. What would be the date on that?
Q. It would be March 10, 1960, and the page -- the
stamp at the bottom
of the page would be 153, Dr. Glenn.
A. I go from 152 to 154. I can read the --
Q. Do we have a copy of that?
Well let me ask you to identify this as page 153,
on the screen.
A. Yes.
Q. And is this the cover sheet to a meeting of the
Scientific Advisory
Board in March 10 and 11 of 1960?
A. It is.
Q. Do you have page 157 there, Dr. Glenn?
A. Yes.
Q. And is 157 a report by the Scientific Advisory
Board to the TIRC?
A. Yes.
Q. And that was part of the minutes of that meeting?
A. Yes.
Q. I'd like you to turn to the next page, 158. Do
you have that, sir?
A. I do.
Q. And ask you to turn to the paragraph that begins
"Even though...."
A. Yes.
Q. And to read that portion of the report of the
Scientific Advisory
Board in 1960.
A. "Even though it must be admitted that the effort
thus far has barely
scratched the surface, excellent scientific studies have been reported,
and
it can confidently be assumed that the facts revealed will ultimately
contribute to the solution of the broad questions which concern us.
But
perhaps the most significant development has been the general recognition
that we do not yet have the answer; that an association between the
extent
of tobacco use and the incidence of lung cancer does not prove a causal
relationship, that experimental verification is essential and that
there
are a number of other factors which need to be considered. Today, instead
of letting the problem rest with the statement that to smoke in excess
of
two packs of cigarettes per day results in a ten-fold increase in the
risk
of cancer, there is general interest in the 90 percent of heavy smokers
who
escape the disease despite heavy smoking. We are also vitally interested
in
the meaning of the results, derived from the same data, that only a
small
fraction of the reported excess deaths in the heavy smoking group is
attributable to cancer of the lungs."
*21 Q. Dr. Glenn, from your standpoint, if one wanted
to find out the
view of the Scientific Advisory Board on the question of causation,
is it a
more reliable source to look to the Scientific Advisory Board's own
report,
or to look to a report from some British people?
MR. CIRESI: Object to the form of the question,
Your Honor.
THE COURT: Sustained.
Q. This is the SAB's own words in 1960; correct?
A. Yes, sir.
Q. Could you turn to Exhibit 11027, Dr. Glenn, which
is at tab 25.
A. I have that.
Q. And is this a --
Is Exhibit 11027 one of the plaintiffs' exhibits
that Mr. Ciresi showed
you the other day?
A. Yes, it is.
Q. Had you ever seen this, apart from litigation?
A. Only in connection with litigation.
Q. Is this document in CRT's files?
A. No, sir.
Q. Who's the author of this document, can you tell?
A. I can't tell. I -- it's --
Having looked at it previously, I couldn't tell
who wrote it.
Q. Is there a signature or a name listed on it anywhere?
A. No, sir.
Q. Are there any direct quotes here from the CTR?
A. No, sir.
Q. Could you turn to the page -- and I'll just give
you the last three
numbers of the Bates stamp in the lower right corner, Dr. Glenn, because
the pages aren't otherwise numbered -- page 269.
A. Yes, sir.
Q. And I'd like to direct your attention to the
first full paragraph at
the top of the page.
A. Yes, sir.
Q. And this is referring to --
This purports to be a report on a conversation with
Dr. Wakeham.
A. Yes.
Q. Can you read what that says?
A. "Wakeham said that polycyclics were effective
in contributing to
cancer in mouse skin painting, but the quantities in smoke were too
small
to be significant, as the Surgeon General Advisory Committee report
had
stated."
Q. Now that says "SGAC," but that refers to Surgeon
General's Advisory
Committee; correct?
A. Yes.
Q. And is that the point you made last Friday in
your testimony?
A. Yes.
Q. Could you turn to the page labeled 290, Dr. Glenn.
A. Yes, I have that.
Q. And does this purport to be a report of a meeting
with Dr. M. H.
Seevers?
A. It is labeled "Discussion with Dr. M. H. Seevers,
Ann Arbor,
Michigan, October 1, 1964."
Q. Did Dr. Seevers have any involvement with the
Surgeon General's
Advisory Committee in 1964?
A. Dr. Seevers was the chairman of the Surgeon General's
Advisory
Committee.
Q. He was a member of that committee; correct?
A. Yes.
Q. Let me just show from the 1964 report a list
of the members here.
That lists Dr. Seevers at the bottom; correct?
A. Correct.
Q. Now this document in front of you purports to
reflect a discussion
with Dr. Seevers in October '64?
A. Yes, sir.
Q. And that's about 10 months after the issuance
of the Surgeon
General's report?
A. Yes.
Q. I'd like you to start reading about AMA research
into smoking and
health there, and I'll have a few questions as we go along, Dr. Glenn.
*22 A. "To date, the committee (of which Seevers
is chairman) appointed
by the Education and Research Foundation of the AMA to direct the programs
for using the 10-million-dollar fund contributed by the U.S. cigarette
manufacturers, has approved 28 grants. The total cost of these over
the
periods for which they have been approved will be $2,400,000. Details
of
the grants are attached."
Q. Okay.
A. "The main considerations" --
Q. Continue, please.
A. "The main considerations which have been in the
minds of the Seevers
committee in making these grants have been:
"(1) It is necessary to get more good people to
undertake research in
the smoking and health field, whether or not they live in the U.S.
"(2) Research into cancer is not excluded but it
has been
over-supported in relation to other aspects. Under-supported have been
research into respiratory disease, cardiovascular disease, cellular
studies, ciliary activity, pharmacological and psycological reasons
for
smoking.
"(3) It is particularly necessary to find means
of determining nicotine
in the blood and organizing a supply of radio-active nicotine. The
Committee aim particularly at developing techniques.
"(4) The Committee do not plan to build their own
laboratory though
they may use the general medical research laboratory being built for
the
ERF of AMA in Chicago.
"Where gaps exist, the Committee will initiate research
projects to
close them. They already have two or three such projects.
"(6) The Committee is not concerned with modifications
to cigarettes,
how to treat tobacco et cetera. The manufacturers are more competent
to do
this. Similarly, the Committee is not concerned with cigarette tars,
which
would require a laboratory for their production.
"(7) The House of Delegates of the AMA, in accepting
the fund, looked
to it being used for the development of safe cigarettes. The Committee
considered that they were not set up to do this, and had no manufacturing
competence, et cetera - Seevers said they had a hard time getting away
from
this objective.
"(8) The Committee would support epidemiological
studies if they
received good applications.
"(9) The Committee may support research in more
fields as they get more
and more projects going.
"(10) They may add other experts (an example, pathologists)
to the
Committee; just feeling their way at present.
"(11) If they find good projects, they won't hesitate
to spend over the
10 million dollars as the AMA would have no difficulty in finding more
money.
"(12) They have refused to finance anti-smoking
clinics or education.
"(13) They expect to co-operate closely with CTR."
Q. Let me stop you there for a moment, Dr. Glenn.
This refers to a 10-
million-dollar grant given by the cigarette manufacturers to the AMA?
A. Yes, sir.
Q. And the AMA set up a board of scientific advisors
to approve
research applications?
A. Yes.
Q. Were you one of the researchers back in those
days who received a
grant from the AMA pursuant to this?
*23 A. My laboratory -- my laboratory, the laboratory
under my
direction, received a grant for study under the American Medical
Association Education and Research Fund.
Q. Would you go to the next page, Dr. Glenn, where
it reports -- the
page that begins "Seevers' personal views...."
A. Yes, sir.
Q. Now again, Dr. Seevers had been on the Surgeon
General's committee
that had issued the report 10 months earlier; correct?
A. Correct.
Q. What does this say about Dr. Seevers' personal
views?
A. "1. Seevers does not believe that it has been
proved that smoking
causes lung cancer. There is an association and it should be made known.
The strongest evidence for a causal connection is Auerbach's work,
but it
is not conclusive. Seevers is not sure the validity of the statistics."
Q. The next --
Could you read the next paragraph as well.
A. "2. Seevers is convinced the main reason why
people smoke is the
nicotine. He thinks it important to keep the nicotine content up. He
has
suggested to Hanmer of The American Tobacco Company that they should
add
back nicotine to cut the tobacco and then reduce both nicotine and
tar, as
in Carlton, by filter and porous paper. To produce a non-tobacco cigarette
was contrary to common sense."
Q. Could you go now, Dr. Glenn, to the page 294.
A. Yes, sir.
Q. And this continues the purported characterization
of the discussions
with Dr. Seevers; correct?
A. Yes.
Q. What does this say about the Surgeon General's
Advisory Committee?
A. "Seevers said that it was a committee of prima
donnas. Although none
of the members had published expressed views on smoking and health
they all
had very definite views. The Surgeon General never came near the committee.
Handley acted as chairman of the meetings; he was pleasant but ineffective,
allowing far too much irrelevant chat. Bains-Jones, as oldest member,
had
to step in from time to time to get points settled. Two whole days
were
spent discussing the meaning of, quote, cause, unquote. The political
people tried to hurry up the committee but did not otherwise try to
influence them. The, quote, member responsible for cancer (probably
Furth)
submitted a draft for the chapter on cancer that had been written by
the
American Cancer Society. This was thrown out."
Q. Now, do you remember the earlier trip report
that we discussed, I
think that was Exhibit 11028 from 1958, and it talked about how there
was a
debate as to what the meaning of "cause" was. Do you remember that?
A. Yes.
Q. And here we see that Dr. Seevers in October 1964,
according to this
document, did not believe that it had been proven that smoking caused
cancer; correct?
A. Yes.
Q. And Dr. Seevers, again according to this document,
says that two
whole days were spent by the Surgeon General's committee discussing
the
meaning of "cause." Do you see that?
A. Yes.
Q. I'd like to turn you now to the 1964 Surgeon
General's report, Dr.
Glenn. What tab is that? I think it's tab 43, MD000102. That's already
in
evidence.
*24 A. I have that.
Q. And could you turn to page 21 then.
A. I have that.
Q. And could you turn to paragraph four, paragraph
number four in the
causality section.
A. Yes.
Q. And this is where, in the introduction, they're
discussing
causality; correct?
A. Yes.
Q. All right. Can you read that to the jury.
A. "It should be said at once, however, that no
member of this
committee used the word 'cause' in an absolute sense in the area of
this
study. Although various disciplines and fields of scientific knowledge
were
represented among the membership, all members shared a common conception
of
the multiple etiology of biological processes."
Q. Let me stop you there. What does "multiple etiology"
mean, Dr.
Glenn?
A. Means that there may be many, many factors involved
in the genesis
of any particular condition, whether it be cancer or other disease.
Q. You mean "etiology" means cause?
A. Means causes.
Q. So this means --
This says everyone agreed that there were many causes.
A. Yes.
Q. Would you continue.
A. "No member was so naive as to insist upon mono-etiology
in
pathologic processes or in vital phenomena. All were thoroughly aware
of
the fact that there are series of events in occurrences and developments
in
these fields, and that the end results are the net effect of many actions
and counteractions."
Q. Now, Dr. Glenn, does the fact that "cause" was
not used in an
absolute sense, the fact that there was a common conception of multiple
etiology, and that no one was so naive as to insist upon mono-etiology,
would you explain how those ideas relate to your statements the other
day
about the importance of defining "cause?"
MR. CIRESI: Objection to the form of the question,
Your Honor. It's a
multiple question. It's also impeaching his own witness.
MR. WEBER: I object and move to strike that comment,
Your Honor. It's
entirely inappropriate.
MR. CIRESI: It's an inappropriate objection, impeaching
their own
witness.
THE COURT: Okay. You'll have to rephrase your question,
counsel.
BY MR. WEBER:
Q. Dr. Glenn, taking into account Exhibit 1127 that
talked about a
definition of "cause "-- you remember that?
A. Yes, sir.
Q. -- and 1128, where we saw Dr. Seevers' personal
views as reported in
that document -- correct?
A. Yes, sir.
Q. -- and taking into account this paragraph four,
do those documents
along with your learning relate in any way to the need to agree upon
a
definition of "cause" when discussing chronic disease?
A. Yes.
Q. Could you explain that.
A. Well I -- I don't know that there's any simple
explanation. We have
said that in order to establish cause, it should be -- it should have
some
universality, that we ought be able to reproduce results. Here in this
document and in the others that we've looked at it is clear that scientists
even 30, 40 years ago were worrying about the same questions. This
has led
to the -- to the recognition that there are multiple risk factors involved
in a number of diseases. And to digress from lung cancer, you can take,
for
example, arteriosclerosis. We know that diet plays a role, the level
of
your cholesterol, we know that activity plays a role, we know that
hormones
play a role, so there are multiple causes of arteriosclerosis. The
same
thing can be said of virtually every disease, that there are a number
of
factors that are involved. We probably have only just seen the tip
of the
iceberg, but at least we've come to the recognition that there are
fundamental problems.
*25 And the thing that the scientific community
has done most
effectively, I think, is to -- is to recognize that there are marked
individual differences which may underlie everything. These individual
differences are genetics. Probably the best thing we can do to avoid
disease is to pick the right parents, because our -- our -- our
inheritance, our genetic makeup --
MR. CIRESI: Your Honor, we're going beyond the scope
of this witness's
examination.
Q. All right, Dr. Glenn, let me move to a different
topic now.
Has CTR, to your knowledge, been represented by
counsel since its
inception?
A. Yes.
Q. Why does a research organization, in your mind,
need to be
represented by counsel?
MR. CIRESI: Objection, Your Honor, it's vague and
overbroad.
THE COURT: I'm not sure that it's relevant, counsel.
MR. WEBER: The relevance is, if you'll give me a
few questions, I'll
make -- make it clear because I'm leading up to a specific situation,
Your
Honor.
THE COURT: Okay.
BY MR. WEBER:
Q. Can you explain why a research organization,
based on your
experience, needs to be represented by counsel?
A. I think there are a variety of reasons. Any research
organization,
any university I've ever been associated with, any hospital, has counsel,
because you enter into contracts for research, you -- you subscribe
to
certain conditions of a grant, you have fiscal responsibility,
responsibility for the money that's involved. There are always antitrust
issues, for example, in an organization such as the CTR.
MR. CIRESI: Excuse me, Your Honor. We're now well
beyond what this
gentleman is here for.
THE COURT: We aren't going to get into his version
of antitrust issues.
MR. WEBER: Not his version of law, but in specific
situations I want to
get into, Your Honor.
Q. Based on your experience at CTR and the fact
that it's sponsored by
companies, independent companies in the marketplace, has CTR received
advice on antitrust issues from time to time?
A. Yes.
Q. Now without revealing any of the substance of
that advice, are you
aware of a situation back in the 1970s when the Scientific Advisory
Board
received advice on antitrust issues?
MR. CIRESI: Your Honor, if he's going to testify
to this, it opens up
the subject, and we will be entitled to the documentation regarding
it,
which has been resisted.
THE COURT: Counsel, I suggest you use extreme care.
MR. WEBER: May I be heard at side bar on this, Your
Honor.
THE COURT: Yes, you may.
(Side-bar conference)
BY MR. WEBER:
Q. Let's talk for a minute, Dr. Glenn, about the
scope of the SAB
research program and its relevance to the purpose of The Council for
Tobacco Research. All right?
First of all let me ask you: Have the companies
ever told you that
CRT's Scientific Advisory Board should avoid certain areas of research?
A. No, sir.
Q. Now do you recall Mr. Ciresi asked some questions
last week about
criticisms of CTR by scientists in the various sponsor companies in
the
sixties and seventies?
*26 A. Yes.
Q. Do you recall that some of those documents suggested
that CTR should
be redirected or restructured?
A. Yes.
Q. That company scientists should be put on its
board?
A. Yes.
Q. That CTR should be made more directly useful
to the industry?
A. Yes.
Q. Was CTR so restructured, Dr. Glenn?
A. No, sir.
Q. Were company scientists put in control of CTR?
A. No, sir.
Q. Was the role of the Scientific Advisory Board
changed because of
these internal criticisms?
A. No.
Q. Was it part of CRT's charter to do research that
the companies'
scientists would find useful or helpful?
A. No.
Q. Do you believe that CRT's grant program over
the years has been
relevant to its charter, the investigation of diseases and disease
processes associated with smoking?
A. Progressively so.
Q. Does the fact that many of these projects don't
specifically say
they relate to tobacco or smoking make that research irrelevant?
A. No, sir.
Q. What I'd like you to -- to do for us is explain
--
Well before I get to it, let me ask this: Has the
type of research
focused on by the Scientific Advisory Board changed over the years
based on
your knowledge of the research that's been funded?
A. Yes, very much so.
Q. Can you explain that?
A. Well I think the best explanation is that there's
been an evolution
of scientific thought. If you go back historically and look at the
very
first medical investigations five hundred years ago, they were anatomic.
The scientists of the time were looking at gross human anatomy. Later
on
they began to focus on abnormal anatomy and diseased organs, but they
were
still looking at things grossly. It was not until the advent of the
microscope that they were able to take a microscopic look at things.
In more modern times it's been obvious that if we're
going to
understand fundamental disease we've got to know what happens within
individual cells, what happens to individual molecules, and specifically
why those cells and molecules go wrong, which is most probably related
to
immunology and genetics. So the focus of research has become more and
more
precise, more and more defined. The same thing has happened to research
sponsored by CTR that's happened in the general scientific community,
and
that is that we're focusing more and more on these fundamental processes.
In the beginning, if you look back historically
at the CTR documents,
the early studies were epidemiological, relating smoking to diseases.
There
were studies of smoke inhalation in animals, exposing animals to cigarette
smoke. They were very broad in their implication, but it didn't say
anything to why does the -- this -- this cause an abnormality. So I
think
the Scientific Advisory Board exhibited tremendous insight as they
began to
focus their research on the more molecular levels, the cellular levels,
and
in recent years the genetic level. This has been in parallel to what's
been
happening at the federal level.
*27 I'm sure you know -- all know that one of the
biggest scientific
projects facing the country today is the so-called human genome project.
What they're -- what the NIH is attempting to do --
MR. CIRESI: Your Honor, this is -- this is well
beyond the scope of
this individual's testimony.
Q. Let me ask -- let me ask you this: Is CTR funding
work in genetics?
A. Yes, sir.
Q. Immunology?
A. Yes, sir.
Q. Molecular biology?
A. Yes, sir.
Q. Microbiology?
A. Yes, sir.
Q. Virology?
A. Yes, sir.
Q. Are all of those fields relevant to the questions
you're looking at?
A. Absolutely.
Q. Has the National Institute of Health been criticized
for undertaking
basic research of this type into diseases as well?
MR. CIRESI: Your Honor, objection, it's totally
irrelevant to this
case.
THE COURT: You can answer that.
A. Yes. There has been criticism that the NIH was
not focused on broad
aspects of disease but more on basic science, and as a matter of fact,
the
director of NIH has defended this vigorously.
Q. That is to say, he's defended doing this molecular
basic research.
A. Yes.
Q. Now last week Mr. Ciresi asked you a question
based on some of your
congressional testimony. Do you remember that?
A. Yes.
Q. And you stated that he wasn't focusing on all
of your congressional
testimony. Remember that?
A. Yes, sir.
Q. Is the explanation of relevance that you've just
given consistent
with that testimony?
A. Yes, it is.
Q. Has CTR research made real and substantial contributions
to
understanding diseases and disease processes associated with smoking?
MR. CIRESI: Objection, calls for speculation, conclusion,
expert
opinion. He's not qualified.
THE COURT: Sustained.
Q. You've been scientific director of CTR?
A. Yes, I have.
Q. You've been a member of the Scientific Advisory
Board of CTR?
A. Yes, I have.
Q. And on the Scientific Advisory Board you've met
with leading
scientists in areas from throughout this country?
A. Yes, sir.
Q. Do you know whether the Scientific Advisory Board
of CTR believes
that its research has made substantial contributions to understanding
the
diseases associated with smoking and health?
MR. CIRESI: Well, same objections, and also calls
for hearsay,
speculation, conjecture.
THE COURT: Well it's --
MR. WEBER: It's a verbal act, Your Honor, and it's
obviously what
they've done as an organization.
THE COURT: Yeah. It's pretty self-serving. I think
we should move on.
BY MR. WEBER:
Q. How do you rate the overall quality of CRT's
research funded through
the SAB, Dr. Glenn?
A. I think it's outstanding.
MR. CIRESI: Your Honor -- excuse me, doctor, excuse
me. Same objection,
he's not been offered on this.
THE COURT: Okay. I'll -- I'll allow him to give
his rating.
A. I think that the track record of the SAB in selecting
research
projects has been absolutely outstanding.
Q. Let me ask you, Dr. Glenn, to turn to Exhibit
1949, which should be
in tab 28. And that's a demonstrative exhibit.
*28 A. I have it.
Q. Is that a demonstrative exhibit that relates
to what the Frank
Statement said about the TIRC?
A. Yes.
MR. WEBER: Your Honor, I'd move the introduction
of Exhibit 1949 for
demonstrative purposes.
MR. CIRESI: I have no objection to this.
THE COURT: Court will receive 1949 for demonstrative
purposes.
BY MR. WEBER:
Q. And again, this might be a little more legible
on these side
monitors than on -- on the big one.
Now this exhibit talks about what the Frank Statement
said about the
TIRC or CTR itself; correct?
A. Correct.
Q. And that portion about the TIRC is highlighted
over there on the
right.
A. Yes.
Q. Now it says that the companies are pledging aid
and assistance to
the research effort. Do you see that?
A. I do.
Q. Did that happen?
A. Yes, sir, it did.
Q. It said it was establishing a joint industry
group consisting of the
undersigned known as the TIRC. Did that happen?
A. Yes, sir.
Q. It said that in charge of the research activities
would be a
scientist of unimpeachable integrity and national repute. Did that
happen?
A. Very definitely.
Q. And who was that scientist?
A. Dr. C. C. Little.
Q. It also said there would be an Advisory Board
of scientists
disinterested in the cigarette industry. "A group of distinguished
men from
medicine, science and education will be invited to serve on this board.
These scientists will advise the committee on its research activities."
Did
that happen?
A. Yes, sir.
Q. Has there been a Scientific Advisory Board throughout
the years for
CTR?
A. There has.
Q. Are you proud of the work you've done for CTR,
Dr. Glenn?
A. Absolutely.
Q. If the grants that CTR through its SAB makes
weren't supported by
money from cigarette companies, do you think anybody would be complaining
about these grants?
MR. CIRESI: Your Honor, objection to the form of
the question.
THE COURT: Sustained.
MR. WEBER: That's all I have, Your Honor. I've got
to move a few things
though.
BY MR. CIRESI:
Q. Good morning, doctor.
A. Good morning, Mr. Ciresi.
Q. When the Frank Statement was put up there, Mr.
Weber quit reading
after the fact pledging aid and assistance to the research effort,
but then
he stopped; didn't he?
A. I don't remember.
Q. You don't remember. Well let me read the rest
of that statement,
"research effort into all phases of tobacco use and health." That was
the
pledge; correct?
A. Yes.
Q. Okay. Now today you talked about a number of
studies that were done;
correct?
A. Yes.
Q. Ones that were done here in Minnesota.
A. Yes.
Q. Tell me which one of those studies dealt directly
with smoking and
health and what was the protocol for that study.
A. I think they all dealt with smoking and health,
because we have to
understand the basic disease process.
Q. That's not what I asked, sir. Tell me which one
of those studies
felt -- or dealt specifically with smoking and health and what was
the
protocol for that study.
*29 MR. WEBER: Objection, Your Honor, it was asked
and answered.
THE COURT: It hasn't been answered. You may answer.
A. All of them.
Q. Sir, tell me the protocol for one of the studies
that dealt
specifically with smoking and health. Tell me the protocol.
A. I can't -- I can't tell you the protocol.
Q. You can't tell me the protocol for any of those
studies; can you,
sir?
A. No. No.
Q. You can't tell us the protocol for any of the
studies conducted by
the entire funding of the CTR over its 40 years; can you?
A. That's true, because the protocol is a scientific
document and I
can't repeat that to you.
Q. So you can't tell us specifically how any of
those studies, if any
of them, dealt specifically with smoking and health; can you, as you
sit
here?
A. Yes.
Q. Sir, then tell me one protocol of one study.
A. I can't tell you the protocol. I can tell you
that understanding
basic disease process is fundamental to unlocking the problem of smoking
and health.
Q. I didn't ask you about the general basic disease
process, I asked
about smoking and health.
MR. WEBER: Object to the --
Q. A specific -- excuse me. A specific protocol
for smoking and health,
can you describe it?
A. No.
MR. WEBER: Object to the introduction and -- and
the commenting, Your
Honor.
THE COURT: Okay. Try and avoid comment, counsel.
Q. Is your answer no, sir?
A. No.
Q. Thank you.
Now you talked about the members of the SAB; correct?
A. Yes.
Q. And how many of those personally have you known
over the years?
A. Well we'd have to look at the list. I don't --
I did not personally
know people who were on the Scientific Advisory Board from 1954, but
I have
known many of them over the years. All of the current members are well
known to me and many of the former members.
Q. All right. So you've known a number. Would that
be a fair statement?
A. I'm sorry?
Q. You have known a number of them. Would that be
a fair statement?
A. Yes.
Q. Okay. And you said that all of the members were
of quality; correct?
A. Yes.
Q. Of integrity; correct?
A. Yes.
Q. Cream of the crop, isn't that what you said?
A. Yes.
Q. Some were members of the National Academy of
Sciences; correct?
A. Yes.
Q. Some were Nobel Prize winners. I think you mentioned
three; correct?
A. Those were grantees.
Q. Grantees. Is that right?
A. Yes.
Q. Now when did the CTR survey all of those individuals
to determine
their opinions whether smoking caused lung cancer?
A. Never.
Q. When did they survey all of those individuals
to determine whether
or not smoking caused COPD?
A. Never.
Q. When did the CTR survey all of those eminent
scientists with respect
to whether or not smoking caused heart disease?
A. Never.
Q. When did the CTR survey all of those eminent
scientists to determine
whether they felt smoking caused oral cancer?
A. Never.
Q. When did CTR survey all of those eminent scientists
to determine
whether they felt smoking caused laryngeal cancer?
*30 A. Never.
Q. When did the CTR survey all of those eminent
scientists to determine
whether or not smoking caused esophageal cancer?
A. Never.
Q. When did the CTR survey all of those eminent
scientists to determine
whether or not they believed smoking caused kidney cancer?
A. Never. But --
Q. When did the CTR --
A. -- you have to ask --
You have to let me finish my answer, Mr. Ciresi.
Q. Sir, I only asked whether they surveyed or not,
and your answer is
no; correct? Is that correct?
A. My answer is no. But there is no point in a survey.
A survey is not
a scientific document. And every eminent scientist that you have alluded
to
certainly had his own opinions about causation and what causation
constitutes, and certainly had his own information about the statistical
relationship of smoking and other activities to the risk of developing
certain diseases, so a survey would have been naive to say the least
and
unfortunate at best.
Q. I understand you like the word "naive," sir.
You've used that
before; haven't you?
MR. WEBER: Objection to the commentary, Your Honor.
Q. Well let me just ask the question very simply.
MR. WEBER: Can I move to strike that?
THE COURT: Counsel --
MR. CIRESI: I'll withdraw it.
THE COURT: Withdraw it. All right.
Q. You've used the word "naive" before; correct?
A. Yes.
Q. Now, when did the CTR survey all of their eminent
scientists as to
whether or not smoking caused bladder cancer?
A. Never.
Q. When did the CTR survey all of their eminent
scientists to determine
whether or not smoking caused pancreatic -- pancreatic cancer?
A. Never.
Q. When did the officials, the executive officers
of the defendant
manufacturing companies, come to the CTR and say, "We think there's
a
controversy. Let's get these eminent scientists in and we, the CEOs
of the
company, want to hear what they say?" When did they do that?
A. Never.
Q. When did the CEOs of any of these companies ever
say, "Please go out
to these eminent scientists and find out whether they believe, based
on all
of their research, that smoking causes any of the diseases that I just
asked you about?" When did they do that, sir?
A. Never, because the term "causation" was inappropriate.
Q. We'll get to that, sir.
MR. WEBER: Object to that again, and move to strike
it, Your Honor.
MR. CIRESI: Well, Your Honor, that wasn't --
MR. WEBER: It's continuing.
THE COURT: I'll allow that comment.
Q. When did the CEOs of any of these companies come
up to you and say,
"How much money that we've given to CTR has specifically been spent
on
smoking-and-health-related research?"
A. They haven't asked that question because they
know that all of the
money has been devoted to that issue.
Q. They've never asked you that; have they, sir?
A. No, sir.
Q. Not any scientist from any of those companies
has ever asked you;
have they?
A. No, sir, because they are well aware that we
are directing our
attention to the fundamental disease processes associated with smoking.
*31 Q. And what you said on Friday with regard to
these grants was that
they're generally in the area of 80 to 85 thousand dollars, and they
allow
young people just getting started to get their feet wet. Isn't that
what
you said?
A. That's correct.
Q. And the vast majority of these grants of CTR
have been to young
people just getting their feet wet; --
A. No.
Q. -- correct?
A. I didn't say that. I said these grants -- these
grants have allowed
young people to get a start, but we've also funded well-established
investigators, such as the Nobel Prize winners that I've told you about.
Q. Well let me direct your attention to page 4775,
when you were
talking about the pages of the grants on an exhibit that was shown
to you
by counsel, and you said as follows: "And the amount of the award is
listed
there, and I would tell you that our average award is something like
80 or
85 thousand dollars a year."
A. That's correct.
Q. "So they're not huge grants. But they are very
good grants,
especially for young people who are just getting their -- their feet
wet."
Is that what you said?
A. Yes, sir.
MR. WEBER: Objection, Your Honor, it's an improper
use of a deposition.
It's not inconsistent.
THE COURT: Sustained.
BY MR. CIRESI:
Q. Now, how many of the CTR awards were for people
just getting their
feet wet? How many?
A. I can't tell you a specific number, but a substantial
number. The
point I was making is that a grant of this magnitude is of extreme
value to
someone who is just getting started in the biomedical research field.
Q. And sir, have you done a survey to determine
how many of these
awards were to people just getting their feet wet?
A. No. We've never done a tabulation.
Q. Have you, in the time you've been with the CTR
--
You've testified a number of occasions; correct?
A. No.
Q. How many times have you testified in your life,
40 times?
A. Perhaps.
Q. Okay. Now in the entire time that you've been
with the CTR, have you
gone out and asked the grantees who are doing the work, "Do you believe
this related to smoking and health?" Have you done that?
A. No, sir.
Q. Have you directed anyone at the CTR to do that,
sir?
A. No, sir.
Q. Have the defendants asked the CTR to ever do
that?
A. No.
Q. Now you talk --
You talked about risks; did you not, sir? The risks
for -- I think you
talked about high cholesterol for heart disease and -- you remember
that
testimony?
A. Yes.
Q. And you were talking about various risk factors;
is that right?
A. Yes.
. I want to hand you the 1989 Surgeon General's report.
MR. CIRESI: May I approach, Your Honor?
THE COURT: All right.
(Document handed to the
witness.)
Q. I'll hand you the entire report, sir, if you
want to look anyplace
to make sure it's in context, and also a part of it.
MR. WEBER: Do you have an exhibit number on that,
Mr. Ciresi?
MR. CIRESI: The 1989 is Exhibit 3821.
*32 MR. WEBER: Thank you.
BY MR. CIRESI:
Q. Now on page 160, is there an estimated risk of
various activities?
A. Yes, there is.
Q. And do you know what that's for, sir?
A. This says "Table 13, Estimated Risk of Various
Activities," and then
it lists activities or cause, and then annual fatalities per one million
exposed persons.
Q. Is that for lung cancer?
A. No, this is in general. It's for a variety of
activities.
Q. Do you know what --
So it's for a variety of activities and which activities
cause death;
correct?
A. Not necessarily cause. It says activity or cause.
Q. Okay.
A. And then it lists the fatalities associated with
that risk.
Q. Now let's take a look, then, at that Table 13.
MR. WEBER: I'm going to object to any questions
about this, Your Honor.
Dr. Glenn testified about risk factors, not about risks of comparable
activities. This is beyond the scope of what -- what his testimony
was.
THE COURT: No, I think that's within the scope.
BY MR. CIRESI:
Q. Now sir, on the left-hand margin it says "Activity
or cause;"
correct?
A. Correct.
Q. And then it has "Annual fatalities for 1 million
exposed persons."
Correct?
A. Yes.
Q. And for active smoking it was 7,000; correct?
A. That's correct.
Q. And for alcohol totally it was 541, 275 by accident
and 266 by
disease; correct?
A. Yes.
Q. And then it went all the way down through work,
swimming, football,
electrocution, et cetera; correct?
A. Yes.
Q. Now when we talk about cause, doctor, last week
we talked about the
Henle Koch postulates; didn't we?
Q. Yes.
Q. And today when you were talking about cause,
you were talking about
universality. Do you remember that word you used?
A. Yes.
Q. And by that you meant that every time someone
was exposed to
something, universally a disease would be produced, according to Henle
Koch; correct?
A. No, I didn't say according to Henle Koch. I talked
about the
universality of risk factors.
Q. You were talking about universality of risk factors
then?
A. Yes.
Q. Is that what you were saying?
A. Yes.
Q. Well the Henle Koch postulates were based on
19th century medical
science; weren't they?
A. Yes.
Q. And we went through those last week; didn't we,
sir?
A. Yes.
Q. And we found that you yourself believed that
certain viruses would
cause a disease regardless of whether they met Henle Koch postulates;
didn't you?
A. Yes.
Q. And one of those was Epstein-Barr; right?
A. Yes.
Q. Your judgment was that caused infectious mononucleosis;
correct?
A. It has been so stated, yes.
Q. And you agreed with that; didn't you?
A. Yes.
Q. It was a cause of infectious mononucleosis; correct?
A. Yes.
Q. How many other causes of infectious mononucleosis
are there, sir?
A. I don't know.
Q. Many, aren't there?
A. Yes.
Q. All kinds of causes of infectious mononucleosis;
correct?
*33 A. As I understand it, yes.
Q. Do you know how many cases of infectious mononucleosis
are caused by
Epstein-Barr?
A. No.
Q. Do you know how many are caused by the other
causes?
A. No.
Q. But you used the word "cause" in that effect;
don't you, sir?
A. I accept your use of the term "cause" in the
lay sense.
Q. And the medical scientists accept that; don't
they, sir?
A. In the lay sense, yes.
Q. Not in the lay sense. Werner Henle, who found
the Epstein-Barr virus
as a cause of infectious mononucleosis, used it in a medical sense;
didn't
he, sir?
A. I don't know.
Q. You just don't know.
A. No.
Q. Okay. Do you know how many cases of lung cancer
are caused by
smoking as contrasted with any other cause?
A. I accept the word "cause" in the lay sense, and
I don't know the
answer.
Q. You don't. But you do know that the attorney
-- or excuse me, the
Surgeon General since 1964 has used the word "cause;" correct?
A. Yes.
Q. And explained the word "cause" in the Surgeon
General's report;
correct?
A. Yes.
Q. And went and talked about the experimental approach
accepted by
scientists which provides a direct method for establishing whether
an
association is causal; correct?
A. I don't follow your question.
Q. The Surgeon General in the 1964 report set forth
the experimental
approach which provides a direc